This RIMI grant proposal is designed to address issues of minority health disparities in terms of prenatal and newborn risk trajectories, and possible etiologies, in economically disadvantaged groups. The focus of this research is to examine physiological and neurological responsiveness to auditory stimulation during the perinatal period, and to correlate these responses with measures of maternal stress associated with economic disadvantage (SES) during pregnancy. This will allow the assessment of relationships between early exposure to stress and later cognitive and physiological disparities in infancy. Dr. Fifer and the Department of Developmental Neuroscience at NYSPI have a long and renowned history of research in the area of prenatal and newborn stress and its impact on infant wellness. Ultimately this creates the potential for the formation of early interventions for mental health disparities in high-risk groups. There are two avenues through which this longitudinal examination will proceed. The first phase looks at variation in fetal responsiveness to auditory stimulation, correlated with measures of maternal stress. Previous studies have shown that maternal anxiety and depression influence fetal heart rate reactivity. These studies examined fetal heart rate reactivity to contemporaneous task-driven maternal stress, in either healthy pregnant women, or women who are found to suffer from anxiety and/or depression disorders. This study will instead assess long-term, chronic stress in pregnant women associated with SES, which is both traditionally defined (income, education) and non-traditionally defined (public assistance, material deprivation, subjective social standing). Using medical records and targeted standardized questionnaires, this study will assess a variety of maternal stress factors in pregnant participants, and correlate those measures with their fetuses' neurobehavioral attention and arousal. The second phase of research assesses subsequent newborn autonomic and CNS reactivity to auditory stimulation and orthostatic challenge (tilt) in those same babies. Tilt has been used in previous work conducted at NYSPI, to explore autonomic reactivity in newborns in an examination of risk factors associated with SIDS. Tilt has been found to offer an effective means of assessing autonomic function in both infants and adults at risk for cardiovascular disease. A pilot study has shown that combining tilt with auditory stimulation is useful in the assessment of arousal thresholds in newborns sleeping in different positions. More recently, EEG analyses during tilt, in combination with heart rate analyses, have been productive in extending our understanding of risk factors associated with SIDS (Grieve, Myers, Stark, Housman &Fifer, 2005). This aspect of the research proposal replicates and extends those studies by examining human newborn HR and EEG responses to auditory stimulation while sleeping in different positions, and carries the potential of assessing cognitive function in the context of perception and attention as well. The final and most fundamental of these analyses is the association of these fetal and infant measures with assessments of prenatal stress; vulnerability caused by the complex factors associated with the economic stress of the pregnant mother. What emerges when these phases of research are taken together is a developmental assessment of the impact of maternal stress on fetal and subsequent newborn, child, and adult physiology, with important implications for the trajectory of physical and mental health disparities in subsequent child development.
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